In memory of our brother and son, Robert Bagnell,
who died moments after being tasered by police in Vancouver, British Columbia on June 23, 2004. Bob was the 7th Canadian to die and the 110th in North America.

Tuesday, July 01, 2003

Each year, a small number of people die suddenly while being restrained. Most of these deaths are associated with individuals who were restrained while being taken into custody during a violent police encounter. Other sudden restraint deaths involve people in detention or residential treatment programs who were restrained during violent encounters while also under the influence of psychiatric medications.

There is a great deal of confusion about the cause and circumstances surrounding restraint-related sudden deaths. What is known is that there is a higher rate of sudden death during restraint encounters. Medical authorities typically have had extreme difficulty in identifying the cause of death by autopsy alone.

The "in-custody" death syndrome was first used to describe unexplained deaths when there was no apparent cause other than a police arrest. Research revealed that these individuals exhibited a form of behavioral disturbance that went beyond the distressed state that police normally face (Connor, 2003). The features of this extreme state, referred to as "excited delirium," include agitation, excitability, paranoia, aggression, great strength, and numbness to pain. When confronted or frightened, these delirious individuals can become oppositional, defiant, angry, paranoid, and aggressive.

There are many known causes of an acute behavioral disturbance (e.g., brain tumors, infection, heat exhaustion, thyroid disease, illegal drugs, psychiatric medications), but excited delirium is a largely unknown medical condition. Excited delirium was originally coined by medical researchers to describe the extreme end of a continuum of drug abuse effects such as cocaine-induced excited delirium (Ruttenber, McAnally, & WetH, 1999). Even though the American Medical Association does not recognize this diagnosis as a medical or psychiatric condition, the National Association of Medical Examiners has recognized it for more than a decade (Costello, 2003). It is used by medical examiners in most major cities. Thus, there is a great deal of controversy regarding the use of this syndrome to explain sudden death while restrained.

Opponents of excited delirium theory say they have never seen any proof that someone can be excited to death. The American Civil Liberties Union (ACLU) and the National Association for the Advancement of Colored People fear that the condition is being exploited and used as a medical scapegoat for police abuse (Costello, 2003). They believe most of these people do not die from drugs or some mysterious syndrome but from confrontation, abuse, and inappropriate use of force and restraint during a violent encounter that should have been avoided. They theorize that the cause is due to the psychological stress of being confronted with aggression that results in further physiological reactions (e.g., adrenaline release, increased heart rate, temperature, strength), leading to death. The fact that many of these deaths happen during or soon after restraint clearly implies police abuse. The ACLU believes that most Incustody deaths are the result of excessive force and improper restraint techniques such as hog tying and the use of pepper spray. Many police departments have banned hog tying, which has been blamed for deaths due to positional asphyxia.

Proponents of excited delirium (e.g., medical examiners, police) argue that people who die of the excited delirium death syndrome while restrained are not the victims of incompetence or brutality (Benner & Isaacs, 1996), but rather victims of their own long-term cocaine and amphetamine abuse, which can trigger this fatal syndrome. According to medical examiners, the force of restraining a weakened individual has nothing to do with the death. Some researches believe that the real cause of death is a long-term use of cocaine, which causes heart disease (Ruttenber et al., 1999). Being high on stimulants and being paranoid lead to delirium and a heightened heart rate, often accompanied by a rise in body temperature.

Researchers believe there is a genetic fault that impairs the brain's ability to increase the number of drug receptors in the brain, which helps pump dopamine and other excess hormones out of the brain. Therefore, drug use results in a dangerously high level of hormones in the amygdala, which brings on the delirium and aggression. Antipsychotic medications may have the same effects as stimulants for those susceptible to excited delirium. Since the 1960s, psychiatrists have documented cases of patients who took large amounts of antipsychotic medication, suddenly became manic and aggressive, and later died, usually after being restrained (Costello, 2003).

What is the impact of this issue on advanced practice psychiatric nurses? As a matter of law, any person who chooses to restrain someone may be charged and found responsible regardless of intended or unintended impact, for this reason alone, the decision to use for ce and restraints should be necessary, reasonable, valid, and used only as a last resort. There are justified and unjustified uses of force and restraint, and nurses need to question whether force and restraint are truly necessary and not used prematurely.

Connor (2003) gives several recommendations for healthcare workers to minimize the occurrence of excited delirium and sudden death in the hospital and treatment centers:

1. Carefully screen and monitor people who have recently started a trial of medication, especially medication that has serious side effects and interaction effects.

2. Learn how to recognize the initial symptoms of delirium.

3. Obtain immediate medical consultation, evaluation, and attention for any person who may suffer from delirium.

4. Contain behavior rather than restrain behavior when the patient is not a danger to self or others.

5. Avoid the use offeree if at all possible and, if needed, use the lowest level of force and method of restraint that would not cause aspiration.

6. Use communication tactics that may calm the individual before using tactics that represent confrontation.

7. Educate others (particularly the police) as to the symptoms, causes, and identification of excited delirium.

Amphetamine morbidity has taken on epidemic proportions, which increases drug-related emergencies. This means there will be an increased need for police to handle such incidents, and therefore an increase in sudden in-custody deaths. More research is needed to determine who is most at risk for excited delirium. One of our highest priorities needs to be educating police officers on how to approach individuals who are demonstrating an acute behavioral disturbance that is not criminal in nature, but a psychiatric condition that requires special care.

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taser-Related Deaths = 1043+ in North America

See "A LIST OF THE DEAD"According to Taser International, the taser had nothing to do with any of these deaths. According to a Reuters investigation, Shock Tactics - Part 1 - The Toll, published on August 22, 2017, more than 150 autopsy reports have cited tasers as the cause or contributor to deaths across the U.S. That number may be higher; however medical examiners and coroners are often not impartial but are instead biased in favour of the Crown or, as has been shown, they are under tremendous pressure from - among others - Taser International, to make a particular finding.See Judge rules for Taser in cause-of-death decisions

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My Brother - Robert Bagnell June 27, 1959 - June 23, 2004

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2) Until such time as independent and unbiased study into the "real world" safety implications of Tasers has been properly completed, a moratorium must be imposed upon these weapons.

3) If, after independent and unbiased study has been completed, the Taser is going to remain in the police arsenal, it must be placed at a level equal to lethal force on the continuum of force and used only as a second-to-last resort.

4) Safety standards must be developed for Tasers. There are currently no Canadian safety standards in place for this weapon.

5) Police must not be allowed to investigate themselves but must be subject to independent and unbiased civilian oversight.

6) Families of people who die in police custody in Canada must be provided with funding so that they may be properly represented by legal counsel.

07. Robert Bagnell, 44 – Vancouver, BC - June 23, 2004 - X26 - "Official" cause of death: Consistent with restraint-associated cardiac arrest due to acute cocaine intoxication and psychosis. Bob's autopsy report showed marks on his body consistent to multiple taser shots, which incidently could not be affirmed by the pathologist because she could not explain those marks.

09. Samuel Truscott, 43 – Kingston, ON - August 8, 2004 - X26 - "Official" cause of death: Heart attack cause by drug overdose and "I can state categorically that the Taser did not play any role whatsoever in his death" said Chief Coroner for Ontario, Jim Cairns

24. Michael Langan, 17, Winnipeg, MB - July 22, 2008 - tasered 1 time - the autopsy report says Langan's death was caused by a heart arrhythmia brought on by the Taser shocks

25. Sean Reilly, 42 - Brampton, ON - September 17, 2008 - Peel Regional Police - X26 - tasered 2 times - the inquest jury will determine the official cause of death, however, “the forensic evidence indicated that the force used by the officers, including the Taser discharge, did not contribute to his death"

27. Trevor Grimolfson, 38 - Edmonton, AB - October 29, 2008, X26 - According to sources, after he was pepper sprayed, Trevor was tasered directly on the chest 5 times and tasered on the back of the neck 2 more times - Edmonton police said he was only tasered 2 times but testing on the tasers proves otherwise - "Official" cause of death: excited delirium brought on by drugs

29. Grant William Prentice, 40 - Brooks, AB - May 6, 2009 - RCMP - tasered 2 times - "Official" cause of death: acute cocaine toxicity and "the medical examiner also concluded the taser did not play a role in the death"

Ain't it the truth!

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80% percent of the population could be moved in either direction

Human rights activist Susan Sontag, when asked what she had learned from the Holocaust, said that 10 percent of any population is cruel, no matter what, and that 10 percent is merciful, no matter what, and that the remaining 80 percent could be moved in either direction.

THE Successes AREN'T the Problem

"The issue is not whether or not the taser can be used in a high percentage of cases to reduce death and/or physical trauma to officers and civilians alike. The issue is whether or not it's OK to kill the rest through ignorance and rationalization just because it's a small percentage ... The successes aren't the problem - the failures are. They're being told that tasers are nonlethal, so they blast away until people can't move. They're killing people by accident." Dave Siegler, father of Raymond Siegler, who died on February 12, 2004

The artistic side of Robert Bagnell

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ROBERT ANGLEN

Robert Anglen, a reporter with The Arizona Republic, documented the first 167 Taser-related deaths. Mr. Anglen launched a journalistic investigation of Taser International, linking the Taser to multiple deaths, among other eye-openers.

At the 2005 Arizona Press Club Awards, Mr. Anglen won first place in the Investigative reporting category. He was the recipient of the Don Bolles Award for his report entitled "Taser tied to 'independent' study that backs stun gun'. “As part of an extraordinarily thorough investigation of Taser International, Anglen uncovered ‘smoking gun’ documents that showed the manufacturer was heavily involved in the key study that purported the devices are safe. Anglen also uncovered conflicts of interest and documented wide-spread problems with Taser safety — a matter of national and international public interest.”

In 2006, Mr. Anglen was a runner up for the Arizona Press Club's Virg Hill Journalist of the Year award. Peter Bhatia of The Oregonian wrote “Robert Anglen is an investigative reporter, pure and simple. Clearly, he is a reporter who, once he sinks his teeth into something, stays with it until the story is done. His ongoing work around the company that makes Tasers speaks to that."